Premysl Fryda, Jan Marek, MediCom a.s. Laser

e-mail: editor@laserpartner.cz

 

Prague has always been a city of international meetings, e.g. F. Pick organized the 1st Congress of the German Dermatological Society in Prague as late as in 1889.  One hundred years later the Velvet Revolution has openned Prague`s horizons again. Then in 1998, the 650th anniversary of Charles University was celebrated and we were really happy to organize the 4th Prague Dermatological Meeting as a joint meeting with the International Society of Dermatology (50 out of 302 participants were foreigners from 11 countries). And now, on October 2 - 6, 2002, the Golden Prague, the City of a Hundred Towers, was the host of a prestigeous medical conference - 11th EADV  Congress! This meeting of the European Academy of Dermatology and Venerology was of interest to all practising clinical dermatologists, reaching the highest scientific and academic level.

EADV was established as a non-profit association in Luxembourg in 1987, in order to support research and education in dermatology and venerology. Its objective is to evaluate the latest outcome of research and medical practice carried out by world`s top experts and to apply it in the methods of treatment. Ms. Jana Hercogova, the president of the congress, was pleased by the fact that Prague was the choice, for never before has EADV held its Congress in any country of the Central and Eastern Europe. In this respect, Prague was a pioneer, and the fact that EADV Committee had authorized the Czech Dermato-Venerological Society to organize such a congress is a reflection of the historical and current prestige of Czech dermatology for the global development of this medical branch. Prof. Martin C. Black, the President of EADV, mentioned that holding a meeting in Prague was worth being remembered, since for many years Europe and its medical specialties had remained politically and culturally divided. However, the collapse of the Berlin Wall in 1989 soon brought an enormous potential to unite Europe, with EADV working hard to encourage and support developing European dermatology. From now on, there is no need to differentiate between Western and Eastern Europe - there is only one Europe, working in harmony  and keen to help each other.

The main motto of the congress was "More than Skin-Deep". According to the Oxtord Dictionary, skin-deep means something superficial, not deep, not lasting, for example a wound, or an impression. And it was the true intention of all the organizers to make the congress of European dermatology much more than only skin-deep, in terms of science, education, sharing experience, reviewing professional global perspectives, and, last but not least, in terms of soul, hospitality, and social programme. More than six thousand accreditted experts in dermatology, plastic surgery, aesthetic medicine and related specialties enjoyed an extensive program, focusing on dermatology, venerology, and other disciplines. During four sunny October days the Prague Congress Centre saw several dozen lectures, courses, seminars and satellite symposia. Attention was paid to the issues of skin tumours, dermatological immunology, latest achievments in the treatments of psoriasis and other chronic skin diseases, modern diagnostics in dermatology with the use of computerized systems etc.

Since Laser Partner is a journal focussed on laser technology, we paid attention mainly to new devices and techniques. EADV Congress was a great, if not a unique, opportunity for the professional public to see all the spectrum of  the latest medical laser technology of leading world`s manufacturers at one place. World`s biggest  laser company, Lumenis, was presenting their new family of IPL, Vascu Light, Clear Light and Light Sheer products. The second biggest laser manufacturer, Candela Corporation displayed, apart from their dye laser systems, also a unique SmoothBeam laser system for collagen remodeling and effective acne treatment. Fotona Slovenia brought its reliable Fidelis and Dualis systems. There were numerous other manufacturers from Italy, Germany, Korea and other countries, catching the eyes of the experts with a wide parade of different modern laser devices. As far as biostimulation laser systems are concerned, the only one exhibitor was MediCom Laser Company presenting its latest version of Maestro/LineScan/BioScan system of LLLT lasers and scanners. 

Much attention was paid to digital dermatoscopy, a non-invasive technique which allows the visual inspection of skin subsurface structures that cannot be appreciated by a naked eye. The first step in digital dermoscopic imaging is represented by the opportunity given by the numerical format to store and retrieve images. As well as an expert can diagnose an early melanoma only on the basis of visual patterns we can understand how the main requirement is represented by the image quality. A digital system allows storing very high resolution pictures (5 to12 megaPixel digital cameras) of the total body sites in order to permit an easy digital-visual retrieve of the analyzed moles. High color stability 3CCD video-systems can be then used to grab at different magnifications the pigmented skin lesions. Digital imaging and pattern analysis allow the translation of morphological parameters into mathematical unambiguous definitions and objective values. Color and shading correction allow not only standardized and reproducible data acquisition, but also their automatic analysis and even comparison of the condition of the same patient after a certain time period.

In the past, permanent hair removal was done by electrocoagulation, electrolysis or a combination of both techniques known as the blend technique. In the last 10 years laser hair removal technique has been developed and refined. The first laser system mentioned in the literature in conjunction with an effective hair removal was a Rubylaser. Lasers functioning is based on a selective photo thermolysis. For hair removal the chromophore should be the pigment localised in the hairbulb. For that reason light should penetrate deep enough to reach the hairbulb and not interfere too much with the epidermal pigmentation. Many patients who like to have laser epilation have more or less epidermal pigment so the choice of the optimum wavelength, pulse duration and fluence is crucial. In this respect it is also necessary to stress the importance of an effective skin cooling, leading technology being the dynamic cooling system. Besides the Rubylaser modern lasers like Alexandride or Nd: Yag-lasers as well as diode lasers and filtered flashlamp pulsed light sources are widely used. Modern lasers offer a good dermatological tool for permanent epilation by selective photothermolysis without scarring the skin.

New technologies were also represented by non-invasive photorejuvenation. Ablative techniques that have been utilised to date in the treatment of photodamaged, ageing skin and scars have sometimes resulted in wounding of the skin and in many cases prolonged wound healing even with possible permanent side effects. More recently lasers and intense pulsed light (IPL) sources have been utilised without ablative injury allowing for stimulation of dermal collagen with subsequent improvement of skin texture, fine lines, skin tone, pigment and vessels. The non-ablative lasers that are best known are 1320 nm Nd:YAG, 590 nm pulsed dye laser (PDL), 1350 nm diode laser and 550-955nm cut-off filter light sources (IPL). They are using wavelengths that do not injure the epidermis and therefore minimising or eliminate post operative sequelae and prolonged recovery. 

At the very end of the Congress the Prague Congress Center hosted Prof. David Goldberg, co-President for the American Society for Laser Medicine & Surgery, delivering a series of lectures on modern trends in laser treatment of vascular lesions, laser hair removal, and laser treatment of rhytides and acne.

Prague EADV congress was a great opportunity to see the top dermatology, top experts, and top technology at one place. Next meeting is to be held in Barcelona. Wait and see new developments...